5 Things California: Budget blueprint, Revised CalAIM proposal, The silent epidemic

If you understand the unique character of our republican democracy, you can find calm in this anxious time. Tomorrow, Joe Biden will be inaugurated President of the United States. He may not have been your candidate. That disappointment is a luxury of being in a democracy.

The orderly transfer of power from one administration to another is something unique to the last few hundred years among almost the entire swath of human history. It transpires again tomorrow, just the 45th time since the enactment of our Constitution in 1789. I would encourage you to watch and appreciate the moment at 9:00 pm PST. Tomorrow is a reminder of how unique our American experiment in self-government is — and how fragile.





With help from Emily Boerger

1. DHCS releases revised CalAIM proposal

DHCS has released an updated CalAIM proposal, introducing key changes following stakeholder feedback and adjustments due to the COVID-19 pandemic. With a new start date slated for January 1, 2022, the new proposal includes significant adjustments to implementation timelines along with clarifications, new requirements, and in one section, a complete rewrite.

The agency published a separate document highlighting major changes made to the initiative since it was first released in 2019. DHCS will host a CalAIM relaunching webinar on January 28, 2021, from 2-3pm to review the new proposal.

2. Health proposals in Newsom’s budget

Gov. Newsom’s $227.2 billion 2021-22 budget proposal, the largest in state history, prioritizes COVID-19 relief, school funding, and economic recovery. Notable health investments include: $122.2 billion for Medi-Cal in 2021-22, $1.1 billion to reignite the CalAIM program, $4.2 billion for the Public Health Department, and $372 million in state funds for COVID vaccinations.

Rather than waiting until June when legislators need to pass the final budget, Newsom has also called on lawmakers to act immediately on about $5 billion in COVID-related policies, including approval of $2.4 billion for stimulus checks and $2.6 billion in federal funds for rental assistance. A proposal to expand Medi-Cal to undocumented seniors is noticeably missing from Newsom’s financial blueprint.


3. The silent epidemic

Research from California Health Policy Strategies shows overdose deaths in California grew 26.8% between June 2019 and June 2020 – surpassing the national growth rate of 21.3% during that same time frame. Experts say this trend, which in part is driven by increases in fentanyl use, will continue to increase as the pandemic continues.

“It’s a wave and it’s not done cresting,” says CHPS researcher Konrad Franco. “If you look in individual counties’ data and in all of 2020, three times more people died in San Francisco [of drug overdoses] than they died of COVID.” After everyone is vaccinated, “we will still be digging out from this,” says Dr. Aimee Moulin, co-principal investigator with the California Bridge Project.


4. CA releases Master Plan for Aging

Lost in the news of a mob breaching the US Capitol, on January 6 the Newsom Administration announced the release of the state’s Master Plan for Aging, outlining five goals and 23 strategies to prepare the state for significant demographic changes expected in the coming years. According to the plan, by 2030 California will be home to 10.8 million people age 60 and older – almost twice as many older adults as there were in 2010.

The plan’s five overarching goals focus on affordable housing, health care, equity & inclusion, caregiving support, and affordability. Reporter Emily Boerger offers a rundown of the strategies and initiatives including in the Master Plan here.

5. Event: Mental health policy in 2021

This Thursday at 9:30 am, we are hosting a panel on “Mental health policy in 2021” as the Biden administration takes the reins tomorrow. This session is part of our Leadership Series, one of our “Virtual Conversations” we have built during this pandemic. The event is free, but you have to register. And, since we are promoting this across our national network, I expect we will have a full event. So, sign up early if you want to be with us.

Tom Insel, MD, will anchor the panel. He is is Gov. Newsom’s mental health czar and one of the most well respected thought leaders on mental health in the country. He will be joined by Andy Keller, the CEO of the Meadows Mental Health Policy Institute based in Texas, as well as by Susan Mims, MD. She is the Interim CEO of the Dogwood Health Trust, one of the country’s largest and newest health care-focused philanthropic foundations.